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Flashcards in Thorax Deck (37):
1

axillary line

is a coronal line on the anterior torso marked by the anterior axillary fold. It's the imaginary line that runs down from the point midway between the middle of the clavicle and the lateral end of the clavicle; the lateral end of the collarbone is the end closer to the arm.

2

types of axillary lines:

anterior medial posterior

3

Terminal duct Lobular Unit

lactiferous sinus, lactiferous duct, terminal duct, acini, lobules,

4

chest anatomy inside out:

intercostal muscle, intercostal vessels, intercostal fascia, superficial abdominal fascia,

5

intercostal vessels

arteries
Posterior intercostal arteries
Highest intercostal artery
Anterior intercostal branches of internal thoracic artery
veins
Supreme intercostal vein
Superior intercostal vein
Posterior intercostal veins

6

suspensory ligaments

Cooper's ligaments (also known as the suspensory ligaments of Cooper and the fibrocollagenous septa) are connective tissue in the breast that help maintain structural integrity.

7

mammary lobes

The breast or mammary gland is a highly efficient organ mainly used to produce milk and is a mass of glandular, fatty, fibrous tissues. Mammary glands are exocrine glands that are enlarged and developmentally are modified sweat glands that are actually part of the skin. They are also classified as tubualveolar glands and are located in the breast lying on the top of the pectoralis major muscles. These glands are present in males and females; however, they normally function in the latter gender only.

8

lactiferous ducts

Lactiferous ducts form a tree branched system connecting the lobules of the mammary gland to the tip of the nipple. They are also referred to as galactophores, galactophorous ducts, mammary ducts, mamillary ducts and milk ducts. They are the structures which carry milk toward the nipple in a lactating female.

9

lactiferous sinus

an expansion in a lactiferous duct at the base of the nipple in which milk accumulates

10

interlobular connective tissue

The interlobular septae are located between secondary pulmonary lobules and are continuous with both the subpleural interstitium (peripheral connective tissue) and the peribronchovascular interstitium (axial connective tissue) as well as the more delicate intralobular septa.

These septae are composed of connective tissues within which run the pulmonary veins and lymphatics which drain towards the pleura (NB a second set of lymphatics runs along with arteries and drains centrally).

11

mammary glands:

lined with milk-secreting cuboidal cells and surrounded by myoepithelial cells
top medial 15%, lower medial 5%, lateral side is 60%,10%,10%

12

mammary glands are

apocrine and merocrine glands

13

vascular supply to breast:

subcalavian vein and artery, axillary artery vein (lateral side), internal thoracic artery and vein (medial side), lateral thoracic artery, vein, medial mammary branches,, lateral mammary branches

14

Venous route of metastases

Breast cancer may metastasize to the vertebral column, brain, etc. as well as the lungs.

15

Lymphatic drainage of the breast

Most lymphatic vessels drain superficially toward the nipple to form a subareolar plexus.
The major collecting vessels from the subareolar plexus drain along the course of the lateral thoracic veins to lymph nodes in the axilla.
A smaller medial portion of the breast drains to parasternal nodes along the internal thoracic artery.

16

Vascularity of thorax

cephalic vein, thoracoacromial artery

17

Radical mastectomy

breast, axillary nodes, and pectoralis muscle are removed

18

Modified radical mastectomy

breast and lateral and central axillary nodes are removed

19

Simple (total) mastectomy

breast, but no axillary nodes or muscle are removed

20

true ribs

The first seven pairs are attached directly to the sternum by costal cartilages and are called true ribs.

21

false ribs

The 8th, 9th, and 10th pairs— false ribs—do not join the sternum directly but are connected to the 7th rib by cartilage.

22

floating ribs

The 11th and 12th pairs—floating ribs—are half the size of the others and do not reach to the front of the body. Each true rib has a small head with two articular surfaces—one that articulates on the body of the vertebra and a more anterior tubercle that articulates with the tip of the transverse process of the vertebra.

23

atypical rib

The first rib is not like the others and is known as atypical rib. It is of great importance clinically because of its close relation with the brachial plexus subclavian vessels (main vessels of the arm). Unlike other ribs, it is flattened from above downwards. It has a tubercle, known as the scalene tubercle, on the inner border. The scalenus anterior muscle is inserted into this tubercle. Anterior to this tubercle, the subclavian vein crosses over the rib while coming out of the upper limb. Posterior to the tubercle, there is a groove known as the subclavian groove through which the subclavian artery and the lower trunk of the brachial plexus cross the rib.

24

costal articulation of first rib

The first costal cartilage of both sides attach to the manubrium sterni. At this joint, no movement is possible.

25

costal articulation of second rib

The second costal cartilage articulates with the body of sternum and the manubrium sterni by a synovial joint where movement is possible. The third to seventh costal cartilages articulate with lateral border of the body of sternum at mobile synovial joints. The mobility of these joints allows the movements of respiration to take place in the rib cage. The sixth, seventh, eighth, ninth and tenth costal cartilages are jointed with each other along the borders by synovial joints. The eleventh and twelfth ribs are floating, which means that they do not articulate in front with the sternum and are embedded in the musculature of abdominal wall.

26

costal articulation of the third-seventh costal cartilage:

The third to seventh costal cartilages articulate with lateral border of the body of sternum at mobile synovial joints. The mobility of these joints allows the movements of respiration to take place in the rib cage.

27

costal articulation of the lower ribs;

The sixth, seventh, eighth, ninth and tenth costal cartilages are jointed with each other along the borders by synovial joints. The eleventh and twelfth ribs are floating, which means that they do not articulate in front with the sternum and are embedded in the musculature of abdominal wall.

28

intercostal space and muscles

External intercostal muscle and membrane—note the direction of fibers
Internal intercostal muscle—note the 90° change in direction of fibers
Innermost layer
Intercostal vein, artery and nerve in the costal groove below the rib
Collateral branch along the superior border of the next rib

29

internal thoracic artery is a branch of the:

subcalavian artery

30

thoracic pleura

A pleura is a serous membrane which folds back onto itself to form a two-layered membranous pleural sac. The outer pleura (parietal pleura) is attached to the chest wall, but is separated from it by the endothoracic fascia. The inner pleura (visceral pleura) covers the lungs and adjoining structures, including blood vessels, bronchi and nerves. The pleural cavity can be viewed as a potential space because the two pleurae adhere to each other (through the thin film of serous liquid) under all normal conditions.

31

pulmonary pleura

the pleural cavity is the thin fluid-filled space between the two pulmonary pleurae (visceral and parietal) of each lung.

32

mediastinum

The mediastinum is the central compartment of the thoracic cavity surrounded by loose connective tissue, as an undelineated region that contains a group of structures within the thorax. The mediastinum contains the heart and its vessels, the esophagus, trachea, phrenic and cardiac nerves, the thoracic duct, thymus and lymph nodes of the central chest.

33

pericardial cavity

The pericardiumis a double-walled sac containing the heart and the roo ts of the great vessels. The pericardial sac has two layers, a serous layer and a fibrous layer. It encloses the pericardial cavity which contains pericardial fluid.

The pericardium fixes the heart to the mediastinum, gives protection against infection, and provides the lubrication for the heart.

34

pleural cavity

The parietal pleura is the outer membrane which is attached to the inner surface of the thoracic cavity. It also separates the pleural cavity from the mediastinum. The parietal pleura is innervated by the intercostal nerves and the phrenic nerve. Between the membranes is a fluid filled space called the pleural cavity.

35

which type of secretion is not used by the mammary gland? epocrine, merocrine, holocrine, apocrine?

holocrine

36

at what intercostal location are you most likely to find lung tissue when inserting a needle along the midclavicular line?

T7

37

The pleural recesses are:

T8-T9 (no more lung), T10-12 (no more pleura)